By Lisa Stiles, Talstone Group, organizing sponsor of HealthCampNash

At last week's inaugural HealthCampNash in Nashville, TN, Paul Meyer, co-founder, president and chairman of Voxiva, led with a keynote presentation, called "Mobile Health - Lessons from Around the World," which included a number of case studies from developing markets as well as a sneak peak of Voxiva's plans in the U.S. Since 2001, Voxiva has been building mobile health applications that address two key questions few traditional healthcare IT vendors consider, namely: 1) Where are the people? and 2) Where is the health?

Voxiva began by creating mobile health services in developing countries (First launch: Peru), so they aimed to leverage the technology people were already using. Meyer offered a number of case studies from countries like Mexico, Kenya and Rwanda where mobile health applications engage patients and change behavior. The services include risk assessment, appointment reminders, adverse event tracking, and satisfaction surveys. 

In Mexico, people are tracking their diabetes, getting tips, and interacting with their providers. In Kenya, they receive medication reminders, and in Peru rural health workers can input a text code for a disease found, such as cholera, where it is updated to their national health system in real time.

In Rwanda, the Ministry of Health implemented a system that uses mobile phones to register patients, order supplies, and access lab results. Meyer states there are 184 studies happening globally that show results for smoking cessation, improvement in diabetics, and even birth outcomes when programs were combined with mobile interaction. For example, in one study 28 percent of smokers receiving quit messages via SMS actually quit, versus 19 percent who do did not. In another study, SMS reminders improved primary care attendance from 48 percent to 59 percent.

These mobile health applications are not relying on high-tech specialty devices that cost several thousands of dollars but are reaching the populations they serve through simple SMS. So why has the United States been so slow to integrate this application? Meyer points out that the U.S. is still the only country in the world where people pay to receive text messages. This puts the burden of cost on the end user and has posed a real obstacle. Also, it wasn't until 2003 that you could even send a text to a friend with a different carrier. Meyer pointed out that there are more text messages sent in a day in Nairobi than in New York City, even though Nairobi has one-third of NYC's population. Although the U.S. is finally starting to catch up to the rest of the world when it comes to mobile technology, we aren't leveraging that technology. The biggest use for Americans with mobile phones? Voting on American Idol.

Although there is a perception that everyone is on in Internet, only 31 percent of the population making less than $35,000 a year has broadband. Meyer pointed out that while only 51 percent of people with chronic illness have Internet access, 90 percent of Americans have mobile phones and 1 trillion text messages were sent last year.

In September, Voxiva, along with the National Healthy Mothers-Healthy Babies Coalition, CDC, the White House, and others, will launch a "Text4Baby" maternal health initiative. The United States has one of the worst infant mortality rates in the world, which is highly concentrated in lower-educated, minority populations. However, the technology penetration in this demographic shows that 85 percent use SMS. The Text for Baby initiative will provide free tips to mothers three times a week before the birth, such as reminders to take a multi-vitamin, to get a flu shot, and so on. After the birth, the mother is reminded about vaccinations, and other health issues.

The impact for a successful initiative could have global potential and can help steer real change in outcomes, which is its goal. Meyer says his company has learned that in developing mobile health it's important to remember that it needs to be people-focused, with engaging messages, and needs to begin by looking at what technology people are using right now.

Lisa Stiles works for the Talstone Group, a healthcare marketing specialist firm located in Nashville, Tennessee. Talstone Group was the organizing sponsor of HealthCampNash.